Note:

1. This record need to be maintained by male/Female nurse of Contractor

2. Where there is no male nusre/ first-aider, then it is the responsibility of contractor safety to maintain record.

Date of medical
Date of Date of leaving Reasons for Results of If suspended from
Nature of job Employment in Raw Material or bye examination by or Transfer to leaving transfer or medical work, state period
Sr.No. Name of Project Name of Building Worker Name of Contractor Designation Sex Age certifying surgeon
or occupation current Project / product handled other Project / discharge from examinatio of suspension with
Medical
work work site n detailed reasons
Inspector/CMO

1 Henkel Sachin Ahire space interrio Safety Officer male 25 09/10/2022 09/10/2022 fit No
2 Henkal vikas vadgama space interrio site engg male 52 09/10/2022 09/10/2022 22/11/2022 left fit No
3 Henkel niraj kumar space interrio fitar plumbing male 21 09/10/2022 plumbing work 09/10/2022 fit No
4 Henkel satyam kumar space interrio Helper plumbing male 20 09/10/2022 plumbing work 09/10/2022 01/12/2022 Left fit No
5 Henkel ajit kumar space interrio fitar plumbing male 24 12/10/2022 plumbing work 12/10/2022 fit No
6 Henkel majubul sk space interrio Helper civil male 28 10/11/2022 tiling work 10/11/2022 fit No
7 Henkel golam hasan space interrio Helper civil male 19 10/11/2022 tiling work 10/11/2022 12/10/2022 Left fit No
8 Henkel Boddu raju space interrio masan civil male 42 10/11/2022 tiling work 10/11/2022 fit No
9 Henkal rintu sekh space interrio masan Civil male 35 10/11/2022 tiling work 10/11/2022 fit No
10 Henkel md sajahan sk space interrio Helper civil male 29 16/11/2022 tiling work 16/11/2022 16/12/2022 Left fit No
11 Henkel md amirul sekh space interrio Helper civil male 31 16/11/2022 tiling work 16/11/2022 25/12/2022 Left fit No
12 Henkel abdul halim space interrio masan civil male 36 02/12/2022 tiling work 02/12/2022 fit No
13 Henkel asgar ali space interrio Helper civil male 26 02/12/2022 tiling work 02/12/2022 fit No
14 Henkel sayem ali space interrio Helper civil male 19 02/12/2022 tiling work 02/12/2022 fit No
15 Henkel dalim sekh space interrio Helper civil male 27 02/12/2022 tiling work 02/12/2022 25/12/2022 Left fit No
16 Henkel abdul karim space interrio masan civil male 36 02/12/2022 tiling work 02/12/2022 25/12/2022 left fit No
17 Henkel ashvni kumar space interrio fitar false flooring male 26 08/01/2023 false flooring 08/01/2023 fit No
18 Henkel durgedeen space interrio Helper _ male 19 08/01/2023 false flooring 08/01/2023 fit No
19
20
21
22